Neutrophil-to-Lymphocyte Ratio and Acute Kidney Injury in Patients with Sepsis Admitted to Intensive Care Unit

Andi Ghina Alya Zurayah; Muhammad Wirawan Harahap; Nurhikmawati Nurhikmawati; Faisal Sommeng; Tirta Swarga

doi:10.20884/1.mhj.2026.6.1.21442

Andi Ghina Alya Zurayah Medical Education Program, Faculty of Medicine, Indonesian Muslim University, Makassar, Indonesia
Muhammad Wirawan Harahap Department of Anesthesiology and Intensive Care, Faculty of Medicine, Indonesian Muslim University, Makassar, Indonesia
Nurhikmawati Nurhikmawati Department of Cardiology and Vascular Medicine, Faculty of Medicine, Indonesian Muslim University, Makassar, Indonesia; Ibnu Sina YW-UMI Hospital, Makassar, Indonesia
Faisal Sommeng Department of Anesthesiology and Intensive Care, Faculty of Medicine, Indonesian Muslim University, Makassar, Indonesia
Tirta Swarga Department of Anesthesiology and Intensive Care, Faculty of Medicine, Indonesian Muslim University, Makassar, Indonesia

DOI: https://doi.org/10.20884/1.mhj.2026.6.1.21442

Abstract

Acute Kidney Injury (AKI) is a common complication in patients with sepsis and contributes to high morbidity and mortality. Early detection of AKI remains challenging because conventional biomarkers have several limitations. The Neutrophil-to-Lymphocyte Ratio (NLR) is an easily obtainable inflammatory marker with potential value in identifying patients at risk of AKI; however, previous studies have reported inconsistent findings. This study aimed to analyze the association between the neutrophil-to-lymphocyte ratio (NLR) and the incidence of acute kidney injury (AKI) in septic patients admitted to the intensive care unit (ICU). This observational analytical study employed a retrospective design using medical record data from 75 septic patients. The mean NLR was significantly higher in patients with AKI than in those without AKI (27.57 vs. 13.66; p < 0.001). Receiver operating characteristic (ROC) analysis identified an optimal NLR cut-off value of 14.45 for predicting AKI, with a sensitivity of 72.7%, a specificity of 81.0%, and an area under the curve (AUC) of 0.788. These findings indicate that a higher NLR is significantly associated with the incidence of AKI among septic patients in the ICU. Therefore, NLR may serve as a useful inflammatory marker to support the early identification of AKI in patients with sepsis.